VZCZCXRO4892
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0304/01 0741027
ZNR UUUUU ZZH
R 141027Z MAR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7412
INFO RUEHHM/AMCONSUL HO CHI MINH 4447
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3303
RUEHKO/AMEMBASSY TOKYO 5845
RUEHHK/AMCONSUL HONG KONG 1381
RUEHGZ/AMCONSUL GUANGZHOU 0884
RUEHCN/AMCONSUL CHENGDU 0348
RUEHIN/AIT TAIPEI 1588
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 03 HANOI 000304 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED 
STATE PASS TO USAID FOR ANE AND GH 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/CHICKEY/DMILLER) AND 
FIC/NIH (RGLASS) AND DIV-FLU (COX/MOHEN) 
CDC FOR COGH (SBLOUNT) AND CCID (SREDD) 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/MBRADY) BANGKOK FOR 
APHIS (NCARDENAS), REO(JWALLER) 
BEIJING FOR HHS HEALTH ATTACHE (BROSS) 
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BBRADY) 
ROME FOR FAO 
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN) 
 
 
E.O. 12958: N/A 
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU VM
SUBJECT: VIETNAM AVIAN INFLUENZA UPDATE: SCATTERED POULTRY OUTBREAKS 
THROUGHOUT COUNTRY 
 
REF: A. HANOI 197 B. HANOI 177 
 
HANOI 00000304  001.2 OF 003 
 
 
¶1. (U) Summary: Provinces in each region of the country have 
reported poultry outbreaks in the past few weeks.  Though localized 
and easily controlled, the number of outbreaks continue to rise and 
are occuring at a rate higher than during the same period last year. 
 A 23-year old woman died on February 25, the ninth consecutive 
human fatality in the current wave of infection that began in May 
¶2007.  The Government of Vietnam (GVN) is again providing prompt 
reports to the World Health Organization (WHO).  At the same time, 
GVN officials acknowledge continuing challenges in responding to the 
disease, including complacency from local officials and the 
population at large.  Additionally, much of Vietnam's supply of 
Tamiflu has expired or may soon do so, forcing the GVN to look for 
other short-term options.  End Summary. 
 
GVN Reports Numerous Poultry Outbreaks 
-------------------------------------- 
 
¶2. (U)  Over the past few weeks, the GVN has reported animal 
outbreaks in nine provinces (Quang Ninh, Hai Duong, Quang Tri, Tuyen 
Quang, Ninh Binh, Vinh Long, Phu Tho, Ha Nam, and Hanoi) scattered 
throughout the country, while declaring four other previously 
infected provinces (Hai Duong, Long An, Nam Dinh, Thai Nguyen) free 
of reported outbreaks for the past 21 days.  Some provinces reported 
multiple outbreaks in different districts.  Typically, the disease 
has struck small flocks of unvaccinated (or just vaccinated) ducks, 
Muscovy ducks, and chickens.  Though localized and easily 
controlled, the outbreaks infected thousands of birds.  After 
testing confirmed the presence of H5N1, animal health officials 
ordered the entire flocks culled. 
 
Including Hanoi 
--------------- 
 
¶3. (U)  The outbreak in Hanoi was the first since March 2007 and 
killed more than 2,000 ducks and chickens at a farm in Hanoi's 
outlying district of Soc Son on March 3 and 4.  Consistent with 
other areas, the outbreak involved ducklings and chickens too young 
for vaccination.  Tran Manh Giang, head of the Hanoi Departmet of 
Animal Health, told the local press that authorities culled the 
remaining ducks and chickens on the farm, began a ten-day 
sterilization period, and banned the transport of poultry from the 
neighborhood.  Nonetheless, Giang expressed concerns that the 
outbreak would spread throughout the district despite the official 
response. 
 
GVN Dissatisfaction with Response in Several Localities 
--------------------------------------------- ---------- 
 
¶4. (U)  The Department of Animal Health (DAH) within the Ministry of 
Agriculture and Rural Development (MARD) publicly expressed concern 
with local efforts to prevent the disease.  According to DAH, 
negligence of local authorities in prevention activities contributed 
to the outbreaks, as these officials failed to effectively monitor 
the development of the disease or to ensure thorough vaccination of 
 
HANOI 00000304  002.2 OF 003 
 
 
local flocks.  Additionally, DAH noted the problem of farmers 
failing to report the deaths of their birds to authorities and 
instead destroying the birds without proper disinfection.  Officials 
fear that animal outbreaks will recur and spread extensively as 
farmers in Mekong Delta provinces use paddy grains left over on 
fields after harvesting to feed new flocks of ducks. 
 
GVN Response 
------------ 
 
¶5. (U)  In response, MARD has launched a month-long campaign too 
disinfect the environment throughout the country in a bid to prevent 
bird flu from spreading.  Vice Minister Bui Ba Bong noted to the 
media that current animal outbreaks were worse than those from last 
year and stated that the campaign would focus on poultry farms, 
waterfowl hatching centers, poultry slaughtering houses and markets. 
 Participants at a MARD-sponsored meeting agreed that central and 
local officials need to focus on vaccinating new birds, 
strengthening quarantine, controlling transportation, trade, 
slaughtering and consuming poultry products, supervising each 
household for early detection and containing the spread of the 
disease and establishing a hot line to update information about the 
disease.  In addition, localities must carry out regular 
sterilisation, apply safe measures in husbandry, check hatching and 
raising units and the strengthen the capacity of locals to comply 
with preventive measures. 
 
Deaths of Civet Cats 
-------------------- 
 
¶6. (U) Separately, on March 12, the media reported that avian 
influenza killed four civets in a Vietnamese national park in Ninh 
Binh province, one of the nine provinces with ongoing poultry 
outbreaks, the second time the rare type of mammal was reported to 
have died there of the H5N1 virus since 2005.  According to a park 
official, four endangered Owston's palm civets died early last month 
at Cuc Phuong Park and tests of their samples found they had the 
H5N1 virus.  Park officials have now banned visitors from the area 
surrounding the civets. 
 
Most Recent Human Fatality 
-------------------------- 
 
¶7. (U) On February 25, a 23 year old woman from Cam Khe District in 
Phu Tho Province (approximately 50 kilometers west of Hanoi) died at 
the National Institute of Infectious and Tropical Diseases (NIITD) 
in Hanoi.  She had become ill on February 14 after preparing and 
sharing a meal of sick household chicken on February 12. 
Reportedly, other chickens in the family flock had already died 
prior to this meal.  She was admitted to a provincial hospital on 
February 19 before transfer to NIITD suffering from respiratory 
failure on February 21.  The National Institute of Health and 
Epidemiology (NIHE) reported positive RT-PCR results to the WHO on 
February 22.  Each of the last nine human cases since May 2007 have 
resulted in deaths.  To date, we have seen no clustering of human 
infections, though we note with concern the high mortality rate in 
 
HANOI 00000304  003.2 OF 003 
 
 
the current wave, which, while based upon a very small sample size, 
may indicate that the virus is mutating into a more virulent form. 
 
 
¶8. (U) Reports of other possible H5N1 infections proved to be 
inaccurate and the victims instead diagnosed with influenza A 
(unconfirmed) and influenza B, both commonly circulating human 
influenza strains.  The severe viral pneumonia component of the U.S. 
Centers for Disease Control and Prevention (CDC) supported national 
influenza sentinel surveillance system detected and enrolled both 
patients.  We estimate that each year approximately 10,000 people 
die from influenza with many more becoming seriously ill, creating a 
challenge for health officials to quickly determine which victims 
suffer from H5N1. 
 
USG Efforts to Ensure Prompt Reporting 
-------------------------------------- 
 
9.(SBU) In response to concerns regarding delayed reporting of 
diagnostic tests to WHO (refs A and B), CDC Influenza Coordinator 
met with officials at the NIHE, the Vietnam Administration of 
Preventative Medicine (VAPM), and Hanoi referral hospitals to urge 
prompt notification and improved internal communications.  Following 
these meetings, both NIHE and VAPM met with the hospitals.  Most 
recently, communications seem to have improved and the GVN 
immediately notified the WHO regarding the positive H5N1 test for 
the latest human victim.  Additionally, the Ministry of Health (MOH) 
continues share information and virus isolates with the WHO 
collaborating center Avian Influenza network, including CDC, and 
VAPM included a WHO staffer in two of its most recent field 
investgations. 
 
Tamiflu Shortage 
---------------- 
 
¶10. (U) NIITD reported a shortage of Tamiflu due to the expiration 
of large portions of its stockpile, which had been donated by Taiwan 
in 2005.  Officials in Hai Duong already encountered this problem 
when trying to provide prophylaxis to relatives and neighbors of a 
young man who died from H5N1 (ref B), while Phu Tho, which has also 
suffered an H5N1 fatality, also reported a lack of Tamiflu. 
Per media reports, MOH has begun to search for new supplies and will 
temporarily use Osetavimin, produced in Vietnam, as a short term 
replacement, while Zuellig Pharma Vietnam (ZPV) donated a stock of 
Tamiflu costing over VND120 million (approximately USD 7,500) for 
use in a few medical facilities. 
 
Michalak